Population-based cohort study of outcomes following cholecystectomy for benign gallbladder diseases

被引：73

作者：

Vohra, R. S. ^{[1
]}

Pasquali, S. ^{[2
]}

Kirkham, A. J. ^{[3
]}

Marriott, P. ^{[4
]}

Johnstone, M. ^{[4
,51
]}

Spreadborough, P. ^{[4
,102
]}

Alderson, D. ^{[5
]}

Griffiths, E. A. ^{[6
]}

Fenwick, S. ^{[7
]}

Elmasry, M. ^{[7
]}

Nunes, Q. ^{[7
]}

Kennedy, D. ^{[7
]}

Khan, R. Basit ^{[8
]}

Khan, M. A. S. ^{[8
]}

Magee, C. J. ^{[9
]}

Jones, S. M. ^{[9
]}

Mason, D. ^{[9
]}

Parappally, C. P. ^{[9
]}

Mathur, P. ^{[10
]}

Saunders, M. ^{[10
]}

Jamel, S. ^{[10
]}

Ul Haque, S. ^{[10
]}

Zafar, S. ^{[10
]}

Shiwani, M. H. ^{[11
]}

Samuel, N. ^{[11
]}

Dar, F. ^{[11
]}

Jackson, A. ^{[11
]}

Lovett, B. ^{[12
]}

Dindyal, S. ^{[12
]}

Winter, H. ^{[12
]}

Fletcher, T. ^{[12
]}

Rahman, S. ^{[12
]}

Wheatley, K. ^{[13
]}

Nieto, T. ^{[13
]}

Ayaani, S. ^{[13
]}

Youssef, H. ^{[14
]}

Nijjar, R. S. ^{[14
]}

Watkin, H. ^{[14
]}

Naumann, D. ^{[14
]}

Emeshi, S. ^{[14
]}

Sarmah, P. B. ^{[14
]}

Lee, K. ^{[14
]}

Joji, N. ^{[14
]}

Heath, J. ^{[15
]}

Teasdale, R. L. ^{[15
]}

Weerasinghe, C. ^{[15
]}

Needham, P. J. ^{[16
]}

Welbourn, H. ^{[16
]}

Forster, L. ^{[16
]}

Finch, D. ^{[16
]}

机构：

[1] Nottingham Univ Hosp NHS Trust, Trent Oesophagogastr Unit, Nottingham, England

[2] Veneto Inst Oncol IOV IRCCS, Surg Oncol Unit, Padua, Italy

[3] Univ Birmingham, Canc Res UK Clin Trials Unit, Birmingham, W Midlands, England

[4] Univ Birmingham, Acad Dept Surg, West Midlands Res Collaborat, Birmingham, W Midlands, England

[5] Univ Birmingham, Acad Dept Surg, Birmingham, W Midlands, England

[6] Univ Hosp Birmingham NHS Fdn Trust, Dept Upper Gastrointestinal Surg, Birmingham B15 2WB, W Midlands, England

[7] Aintree Univ Hosp NHS Fdn Trust, Liverpool, Merseyside, England

[8] Airedale Dist Gen Hosp, Steeton, W Yorkshire, England

[9] Wirral Univ Teaching Hosp, Birkenhead, Merseyside, England

[10] Barnet & Chase Farm Hosp, Enfield, Middx, England

[11] Barnsley Dist Gen Hosp, Barnsley, England

[12] Basildon Univ Hosp, Basildon, England

[13] Sandwell & West Birmingham Hosp NHS Trust, Birmingham, W Midlands, England

[14] Heart England Fdn NHS Trust, Birmingham, W Midlands, England

[15] Blackpool Teaching Hosp NHS Fdn Trust, Blackpool, England

[16] Bradford Teaching Hosp NHS Fdn Trust, Bradford, W Yorkshire, England

[17] Univ Hosp Bristol NHS Trust, Bristol, Avon, England

[18] Broomfield Hosp, Broomfield, England

[19] Calderdale & Huddersfield NHS Trust, Huddersfield, W Yorkshire, England

[20] Hull & East Yorkshire NHS Trust, Kingston Upon Hull, N Humberside, England

[21] Chesterfield Royal Hosp NHS Fdn Trust, Calow, England

[22] Colchester Hosp Univ NHS Fdn Trust, Colchester, Essex, England

[23] Countess Chester NHS Fdn Trust, Chester, Cheshire, England

[24] Croydon Hlth Serv NHS Trust, Croydon, England

[25] North Cumbria Univ Hosp Trust, Whitehaven, England

[26] Plymouth Hosp NHS Trust, Plymouth, Devon, England

[27] Mid Yorkshire NHS Trust, Dewsbury, England

[28] Northern Lincolnshire & Goole NHS Fdn Trust, Scunthorpe, England

[29] Doncaster & Bassetlaw Hosp NHS Fdn Trust, Doncaster, England

[30] Dorset Cty Hosp NHS Fdn Trust, Dorchester, England

[31] North Bristol NHS Trust, Bristol, Avon, England

[32] Freeman Rd Hosp, Newcastle Upon Tyne, Tyne & Wear, England

[33] Frimley Pk Hosp NHS Trust, Frimley, England

[34] Gloucestershire Hosp NHS Trust, Gloucester, England

[35] Great Western Hosp NHS Fdn Trust, Swindon, Wilts, England

[36] Harrogate & Dist NHS Fdn Trust, Harrogate, England

[37] Wye Valley NHS Trust, Hereford, England

[38] Homerton Univ Hosp NHS Trust, London, England

[39] Tees Hosp NHS Fdn Trust, Northallerton, England

[40] Paget Univ Hosp NHS Fdn Trust, Gorleston On Sea, Great Yarmouth, England

[41] Oxford Univ NHS Trust, Oxford, England

[42] Kettering Gen Hosp NHS Fdn Trust, Kettering, England

[43] Barking Havering & Redbridge Univ Hosp NHS Trust, Romford, Essex, England

[44] Kings Mill Hosp, Sutton In Ashfield, England

[45] Kingston Hosp NHS Fdn Trust, Kingston Upon Thames, Surrey, England

[46] Univ Hosp Leicester NHS Trust, Leicester, Leics, England

[47] Mid Cheshire Hosp NHS Fdn Trust, Leighton Hosp, Crewe, England

[48] Luton & Dunstable Univ Hosp NHS Fdn Trust, Luton, Beds, England

[49] Macclesfield Hosp, Macclesfield, Cheshire, England

[50] Cent Manchester NHS Fdn Trust, Manchester, Lancs, England

来源：

BRITISH JOURNAL OF SURGERY | 2016年 / 103卷 / 12期

关键词：

LAPAROSCOPIC CHOLECYSTECTOMY; DELAYED-CHOLECYSTECTOMY; HOSPITAL READMISSION; RISK-FACTORS; QUALITY; COMPLICATIONS; CONSEQUENCES; MORTALITY; REASONS; SURGERY;

D O I：

10.1002/bjs.10287

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background: The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all-cause 30-day readmissions and complications in a prospective population-based cohort. Methods: Data were collected on consecutive patients undergoing cholecystectomy in acuteUKand Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all-cause 30-day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results: Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16.3 per cent) were performed as an emergency, 4165 (46.8 per cent) as elective operations, and 3293 patients (37.0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7.1 per cent (633 of 8909) and 10.8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Conclusion: Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics.

引用

页码：1704 / 1715

页数：12

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